Fahamka Narrowband UVB Phototherapy

Daawaynta doorashada ee cudurka psoriasis, vitiligo, iyo cambaarta

Daawaynta UVB ee cidhiidhiga ah - Aasaaska

"Narrowband" UVB waxay noqotay daawaynta sawir-qaadista sababtoo ah waxay bixisaa xadiga ugu badan ee mowjadaha ugu faa'iidada badan ee iftiinka UV, iyada oo la yareeynayo hirarka dhererka khatarta ah. 

caadiga ah "Broadband" Laambadaha UVB waxay sii daayaan iftiin ballaaran oo ka sarreeya spectrum UVB, oo ay ku jiraan labadaba hirarka daweynta ee gaarka ah ee daaweynta cudurrada maqaarka, iyo hirarka gaaban ee mas'uulka ka ah qorrax-gubashada (erythema). Qorraxdu waxay leedahay faa'iido daweyn oo taban, waxay kordhisaa halista kansarka maqaarka, waxay keentaa raaxo la'aan bukaanka, waxayna xaddidaysaa qaddarka daweynta UVB ee la qaadan karo.  

"cidhiidhi ah" Laambadaha UVB, dhinaca kale,, waxay sii daayaan iftiin badan oo dhererkoodu aad u gaaban yahay oo ku urursan baaxadda daweynta iyo inta ugu yar ee gubashada qorraxda, iyagoo ka faa'iideysanaya "meel macaan" oo u dhexeeya labada qiyaastii 311 nm. UVB-Narrowband sidaas darteed aragti ahaan waa ka badbaado badan yahay oo ka waxtar badan yahay UVB-Broadband, laakiin waxay u baahan tahay waqtiyo daweyn oo dheer ama qalab leh nalal badan si loo gaaro qiyaasta ugu badan, taas oo ku socota bilawga yar ee maqaarka khafiifka ah ee casaanka ka dib daaweynta, loo yaqaan "sub-erythema" . Noocyada UVB-Narrowband ee Solarc waxay leeyihiin daba-gal "UVB-NB" lambarka moodeelka, sida 1780UVB-NB. Moodooyinka Solarc ee UVB-Broadband waxay leeyihiin oo kaliya "UVB", sida 1740UVB. "Narrowband UVB" waxaa sameeyay Philips Lighting of Holland waxaana sidoo kale loo yaqaannaa: Narrow Band UVB, UVB Narrowband, UVB‑NB, NB‑UVB, TL/01, TL-01, TL01, 311 nm, iwm. "01" waa koodka phosphor ee Philips oo ku dhex-yaalla lambarrada qaybta UVB-Narrowband).

Iyo sharaxaad faahfaahsan: 

Fahamka Narrowband UVB Phototherapy

"Narrowband" UVB (UVB-NB) waxay noqotay daawaynta sawir-qaadista ee doorashada psoriasis, vitiligo, dermatitis atopic (eczema), iyo xanuunada maqaarka ee kale ee ka jawaab celinta. Fahamka faa'iidooyinka "Narrowband" UVB iyo "Broadband" UVB phototherapy ee caadiga ah waxay u baahan tahay fahamka iftiinka iyo hababka ay saameynayso.

Muuqaalka shucaaca indhaha (iftiin) waxa uu ka kooban yahay mowjadaha dhaadheer ee kala duwan ee "iftiin" oo u dhexeeya 100 nanometers (nm) ee ultraviolet (UV) ilaa 1 millimitir (mm) gudaha infrared (IR). Iftiinka muuqda wuxuu u dhexeeyaa qiyaastii 380 nm (violet) ilaa 780 nm (casaan) waxaana loo yaqaan "midabka" ee aan ku aragno indhaheena. Ultraviolet waa mid aan la arki karin oo u dhexeeya 380 nm ilaa 100 nm, waxaana loo sii kala qaybiyaa UVA (315-380 nm), UVB (280-315 nm), iyo UVC (100-280 nm).

Sawirka A waxay tusinaysaa xooga isirka “iftiinka” dabiiciga ah ee gaadhaya oogada dhulka kadib marka lagu sifeeyo jawiga dhulka. Aadamuhu waxa ay u xuubsiibteen in ay la kulmaan mawjadahan dhererkoodu dhan yahay, sidaa awgeed maqaarkeenu waxa uu sameeyay jawaabo si uu iftiinka faa'iido ugu yeesho (Vitamin D) iyo in uu inaga ilaaliyo soo-gaadhista xad-dhaafka ah (midabaynta maqaarka iyo maqaarka oo la iska dhaxlo). "UVB Narrowband" waxaa lagu iftiimiyay 311 nm waxayna ku dhacdaa si dabiici ah iftiinka qorraxda, laakiin maaha mid aad u badan. Jawiga dhulku wuxuu sifeeyaa ku dhawaad ​​dhammaan iftiinka wax ka yar 300 nm.
fahamka narrowband uvb phototherapy
narrawband uvb phototherapy

Mawjadaha kala duwan ee "iftiin" waxay soo saaraan saameyno kala duwan oo ku saabsan alaabta. Nidaamyo badan oo muhiim ah ayaa si cilmiyeysan loo darsay si loo go'aamiyo ka qayb qaadashada mawjadaha dhererka kasta ee habka la bartay. Garaafyada loo yaqaan "spectrum action" ayaa loo isticmaalaa in lagu qeexo cilaaqaadkan. Markasta oo ay bataan “xasaasnaanta falcelinta falcelinta”, waa inta ka jawaabida habka dhererka hirarkaas.

Waxa la darsay falgalka spectrum ee cudurka psoriasis1,2 si loo go'aamiyo in mawjadaha ugu daweyntu ay yihiin 296 ilaa 313 nm. Sida ku cad MUUQAALKA B, Laambadaha caadiga ah ee UVB-Broadband ayaa daboolaya xadkan waxaana si guul leh loo isticmaalay in ka badan 60 sano.

Waxa kale oo la darsay spectrum-ka ficilka "gubashada qorraxdu" ee maqaarka bini'aadamka, oo sidoo kale loo yaqaan "erythema".11 Erythema waxaa u badan hirarka dhaadheer ee hoose (in ka yar 300 nm) ee baaxadda UVB. Nasiib darro, nalalka caadiga ah ee UVB-Broadband waxay soo saaraan xaddi badan oo "iftiin" ah oo ku jira xadkan erythemogenic. Mawjadahani waxay soo saaraan gubasho waxayna leeyihiin qiime daweyn oo yar. Intaa waxaa dheer, bilawga gubashada waxay xaddidaysaa qiyaasta UVB3 iyo erythema waa arrin halis u ah kansarka maqaarka. Erythema sidoo kale waxay keentaa raaxo la'aan bukaanka, taas oo laga yaabo inay niyad jabiso bukaanada qaarkood qaadashada daawaynta. Meesha hadhka cawlan ee Sawirka C wuxuu bixiyaa matalaad garaafeed ee nuxurka erythemogenic ee la taaban karo ee UVB-Broadband.

uvbbroadband erythema fahamka cidhiidhiga ah ee uvb phototherapy

"Haddaba waa maxay sababta aan loo horumarinayn il iftiin ah oo soo saarta inta badan wax soo saarkeeda ee falcelinta cudurka psoriasis oo yaraysa iftiinka erythema action spectrum?"

uvbnarrowband erythema fahamka cidhiidhiga ah ee uvb phototherapy

Dabayaaqadii 1980-meeyadii, Philips Lighting of Holland waxa uu soo saaray laambad caynkaas ah, oo loo yaqaannay “TL-01” ama “UVB Narrowband”. Meesha hadhka cawlan ee yar ee ku taal SAWIR D Waxay tusinaysaa in nalalka UVB-Narrowband ay leeyihiin wax soo saarka erythemogenic aad uga yar (awood gubasho) marka loo eego laambadaha caadiga ah ee UVB-Broadband. Tani waxay ka dhigan tahay in daweyn badan oo UVB ah la bixin karo ka hor intaysan dhicin erythema, iyo maadaama erythema ay tahay arrin halis u ah kansarka maqaarka, nalalkan cusub waa inay aragti ahaan ka yareeyaan kansarka natiijadii daaweynta isku midka ah.4,5,6,7. Intaa waxaa dheer, oo muhiim u ah guusha uu arkay guriga UVB-Narrowband phototherapy, waxay noqoneysaa mid aad u macquul ah in cudurka la xakameeyo iyada oo aan waligeed la gaarin marinka erythemogenic.9,10, Kaas oo had iyo jeer dhibaato ku ahaa daawaynta UVB-Broadband. Waxaa xiiso leh in la ogaado in meesha ugu sarreysa ee qalooca UVB-Narrowband ay ku dhowdahay toban jeer ka sarreeya qalooca UVB-Broadband, sidaas darteed isha magaca "Narrowband".

Daraasado dhowaan la sameeyay ayaa xaqiijiyay natiijooyinkan waxayna sidoo kale go'aamiyeen in UVB-Narrowband ay leedahay shilal gubasho oo ka yar iyo waqtiyo cafis ka badan UVB-Broadband. Marka la barbar dhigo PUVA (Psoralen + UVA-1 light), UVB-Narrowband waxay leedahay waxyeelo aad u yar waxayna badashay xaalado badan8.

Mid ka mid ah khasaaraha UVB-Narrowband waa taas, sababtoo ah qiyaasta ugu badan waxay xaddidan tahay bilawga erythema yar, iyo UVB-Narrowband way ka yar tahay erythemogenic marka loo eego UVB-Broadband, waqtiyo daaweyn oo dheer ayaa loo baahan yahay. Tan waxaa lagu magdhabi karaa iyadoo la kordhinayo tirada nalalka qalabka4,5,6,7. Tusaale ahaan, iyadoo lagu saleynayo daawaynta guriga ee Solarc ka dib dabagalka iibka ee UVB-Broadband, 4-nambar 1740UVB waxay bixisaa waqtiyo daawaynta macquulka ah; Halka UVB-Narrowband, 8-namb 1780UVB-NB ay tahay doorasho guud. Saamiga aragtiyeed ee kartida erythemogenic ee UVB-Broadband ilaa UVB-Narrowband waa inta u dhaxaysa 4:1 ilaa 5:1.

Cudurada kale sida vitiligo, canbaarta, mycosis fungoides (CTCL), iyo qaar kale oo badan ayaa sidoo kale si guul leh loogu daaweeyay UVB-Narrowband, guud ahaan sababo la mid ah sida kor lagu sharaxay cudurka psoriasis.

Faa'iidada kale ee xiisaha leh ee UVB-Narrowband waa in ay u badan tahay nooca ugu fiican ee nalka fluorescent ee samaynta Vitamin D (Sawirka E) maqaarka bini'aadamka, si loogu isticmaalo halkii laga isticmaali lahaa iftiinka qorraxda dabiiciga ah (oo ay ku jiraan UVA waxyeello leh), ama kuwa aan nuugi karin Vitamin D (kiniiniyada) afka oo ku filan dhibaatooyinka mindhicirka. Mawduuca Faytamiin D ayaa dhawaanahan helay dareen warbaahineed oo aad u wanaagsan, iyo sabab wanaagsan. Faytamiin D-gu waa lama huraan u ah caafimaadka bini'aadamka, haddana dad badan ayaa ku liidata, gaar ahaan kuwa ku nool loolka sare, kana fog dhulbaraha dhulka. Waxaa jira cadeymo sii kordhaya oo muujinaya in Vitamin D uu ka ilaaliyo horumarinta cudurro badan oo dabadheeraad ah, oo ay ku jiraan kansarka (naaska, colorectal, prostate), cudurrada wadnaha iyo xididdada dhiigga, sclerosis badan, osteomalacia, osteoporosis, nooca 1 diabetes mellitus, rheumatoid arthritis, hypertension, iyo niyad-jabka. Wixii macluumaad dheeraad ah, fadlan booqo boggaga internetka: Faytamiin D Daawaynta Sawirka FAQ & Laambadaha loogu talagalay Vitamin D.

uvbnarrowband vitamind fahamka cidhiidhiga ah ee uvb phototherapy

Fikradda ka jirta bulshada maqaarka ayaa ah in UVB-Narrowband ay ugu dambeyntii bedeli doonto UVB-Broadband sida ikhtiyaar daawaynta, gaar ahaan daawaynta guriga. Tan waxaa si cad u taageeray nidaamka Solarc Systems' ee iibka qalabka sawir-qaadista guriga, iyadoo iibinta aaladaha UVB-NB ay hadda ka sarreeyaan iibka UVB-BB qiyaastii 100:1. Noocyada UVB-Narrowband ee Solarc waxay leeyihiin daba-gal "UVB-NB" lambarka moodeelka, sida 1780UVB-NB. Moodooyinka UVB-Broadband ee Solarc waxay leeyihiin oo kaliya "UVB", sida 1740UVB.

Nidaamyada Solarc waxay jeclaan lahaayeen inay u mahadceliyaan dadka wanaagsan ee Philips Lighting si ay u horumariyaan khadka wax soo saarka UVB-Narrowband, iyo caawinta in badan oo naga mid ah adduunka oo dhan si badbaado leh oo wax ku ool ah u maarayn dhibaatooyinka maqaarkayaga. Fiiro gaar ah: Tirooyinka lagu isticmaalo dukumeentigan waa matalaad la fududeeyay. Qallooca UVB-Broadband waxa uu ka yimid Solarc/SolRx 1740UVB iyo UVB-Narrowband curve waxa laga soo qaatay Solarc/SolRx 1760UVB‑NB.

Waxaan kugu dhiirigelinaynaa inaad sii baadho mawduucan muhiimka ah.

Tixraacyo:

1 PARRISH JA, JAENICKE KF (1981) Waxqabadka Spectrum ee daawaynta cudurka psoriasis. J Maalgelinta Dermatol. 76 359
2 FISCHER T, ALSINS J, BERNE B (1984) Dhaqdhaqaaqa Ultraviolet-ka iyo qiimaynta nalalka ultraviolet ee bogsashada cudurka psoriasis. Int. J. Dermatol. 23 633
3 BOER I, SCHOTHORST AA, SUURMOND D (1980) UVB phototherapy ee cudurka psoriasis. Maqaarka 161 250
4 VAN WEELDEN H, BAART DE LA FAILLE H, YOUNG E, VAN DER LEUN JC, (1988) Horumar cusub oo ku daaweynta UVB ee cudurka psoriasis. Wargeyska Ingiriiska ee Maqaarka 119
5 KARVONEN J, KOKKONEN E, RUOTSALAINEN E (1989) 311nm UVB nalalka daawaynta cudurka psoriasis ee nidaamka Ingram. Acta Derm Venereol (Stock) 69
6 JOHNSON B, GREEN C, LAKSHMIPATHI T, FERGUSON J (1988) daawaynta shucaaca ultraviolet ee cudurka psoriasis. Isticmaalka laambad cusub oo cidhiidhi ah UVB. Proc. 2-Eur. Photobiol. Congr., Padua, Italy
7 GREEN C, FERGUSON J, LAKSHMIPATHI T, JOHNSON B 311 UV phototherapy - Daawaynta waxtarka leh ee cudurka psoriasis. Waaxda maqaarka, Jaamacadda Dundee
8 TANEW A, RADAKOVIC-FIJAN S, SC
HEMPER M, HONIGSMANN H (1999) Narrowband UV-B phototherapy vs photochemotherapy ee daawaynta nooca cudurka psoriasis. Arch Dermatol 1999;135:519-524
9 WALTERS I, (1999) Suberythematogenic-band cidhiidhi ah UVB ayaa si muuqata uga waxtar badan UVB-ga caadiga ah ee daaweynta cudurka psoriasis vulgaris. J Am Acad Dermatol 1999;40:893-900
10 HAYKAL KA, DESGROSEILLIERS JP (2006) Unugyada Guriga ee Ultraviolet B ma yihiin ikhtiyaar macquul ah oo loogu talagalay daawaynta joogtada ah ama dayactirka cudurrada maqaarka ee ka jawaaba sawirka? Joornaalka Daawada Cutaneous & Qalliinka, Caddadka 10, Cadadkii 5: 234-240
11 Tixraaca Erythema spectrum action spectrum iyo standard erythema dose ISO-17166:1999(E) | CIE S 007/E-1998
12 Waxqabadka Spectrum ee Soo saarida Previtamin D3 ee Maqaarka Aadanaha CIE 174:2006